Open or laparoscopic procedures
with:
entry into urinary tract
entry into vagina (including vaginal repair/ vaginal sling/ transvaginal tape/ bladder repair/ cystocele/ rectocele/ pelvic organ prolapse +/- graft/ mesh). Note: Treat bacterial vaginosis pre-operatively if present. If found incidentally at time of surgery, treat immediately intra-operatively and for 4 days post-operatively.
percutaneous renal surgery
Note: If positive urine culture pre-operatively, institute treatment according to culture and susceptibility results.
Common Pathogens
Enterobacteriaceae
Enterococcus spp
Staphylococcus spp
Streptococcus spp
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| Cefazolin | 2g IV | x 1 pre-op dose |
| If entry into rectum, add: | ||
| Metronidazole | 500mg IV | x 1 pre-op dose |
| Alternative Regimens if allergy to cefazolin, or severe non-IgE-mediated reaction to any β-lactam (interstitial nephritis, hepatitis, hemolytic anemia, serum sickness, severe cutaneous reactions [e.g. SJS, TEN, DRESS]) | ||
|---|---|---|
| Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |
| + | ||
| Clindamycin | 600mg IV | x 1 pre-op dose |